Human Reproduction, Vol 13, 3128-3131, Copyright © 1998 by Oxford University Press
Y Abramov, U Elchalal and JG Schenker
The objective of this study was to define the incidence of febrile
morbidity and its causes in severe and critical ovarian hyperstimulation
syndrome (OHSS). For this purpose, we reviewed the medical records of all
OHSS patients hospitalized in 16 out of 19 tertiary medical centres in
Israel between January 1987 and December 1996. Febrile morbidity was
defined as at least one episode of temperature rise above 38 degrees C
lasting > or =24 h. A total of 2902 patients (3305 hospitalizations)
with OHSS was identified, of whom 196 had severe, and 13 critical, OHSS.
Among the 209 patients investigated the incidence of febrile morbidity was
82.3%, of which 20.5% was attributed to urinary tract infection, 3.8% to
pneumonia, 3.3% to upper respiratory tract infection, 2.0% to intravenous
line phlebitis, 1.0% to cellulitis at an abdominal puncture site, 1.0% to
postoperative wound infections and 0.5 % to gluteal abscess at the site of
progesterone injection. Non-typical organisms were frequently isolated,
such as Pseudomonas, Proteus, Klebsiella and Enterobacter species. No
infectious aetiology was found in 105 patients (50.2%). Hypoglobulinaemia
was recorded in most patients, while ascitic and pleural fluids aspirated
from these patients contained high globulin concentrations. We conclude
that infection-related febrile morbidity in severe and critical OHSS is
high, and may be attributed to some degree of immunodeficiency associated
with loss of plasma globulins to the third space. However,
non-infection-related febrile morbidity is even higher and may be
attributed to endogenous pyrogenic mechanisms.
REVIEWS
Febrile morbidity in severe and critical ovarian hyperstimulation syndrome: a multicentre study
Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
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